Abstract

This study aimed to investigate the effects of authentic leadership and organizational culture, perceived by nurses working at medical institutions, on work meaning and work engagement, which are job attitudes, through the mediators, leader-member exchange and psychological capital, in 301 nurses working at three general hospitals with over 300 beds. The analysis results showed that authentic leadership perceived by nurses had a direct effect on enhancing leader-member exchange (β=0.95, p=0.004), and organizational culture had a direct effect on increasing psychological capital (β=0.56, p=0.004). Organizational culture had an indirect effect on increasing work meaning (β=0.32, p=0.004), and psychological capital had a direct effect on increasing work meaning (β=0.56, p=0.004). Work meaning had a direct effect on enhancing work engagement (β=0.89, p=0.004), and organizational culture had an indirect effect on enhancing work engagement (β=0.41, p=0.004). In addition, psychological capital had a direct effect (β=0.62, p=0.004) and an indirect effect (β=0.33, p=0.004) on enhancing work engagement. Therefore, it is necessary to develop human resource management programs that consider authentic leadership of the leader and organizational culture, and mediating effects of leader-member exchange and psychological capital in order to improve job attitudes of nurses.

Keywords

Authentic leadership, Engagement, LMX, Meaning, Psychological capital

Introduction

Recently, changes in the healthcare environment have been gradually accelerating in Korea, and there is an urgent need for strategies to cope with these changes [1]. In particular, the importance of positive job attitudes of nurses who occupy the largest number of personnel in hospitals is emphasized [2]. In recent years, it has been reported in the nursing organization that if work meaning is enhanced, which is a positive job attitude, the quality of nursing is improved, as well as hospital achievement, as work engagement increases [3]. Studies have been conducted focusing on psychological capital, which is an emotional state that members have already been accumulating, and leader-member exchange (LMX) in the organization as mediators that may influence positive job attitudes [4]. Moreover, Henderson et al. suggested that multiple levels of precedence factors could make an influence in this psychological process. Organizational culture and leadership at the organizational level are not only interacting with each other, but are also key factors affecting the psychological processes of the members [5]. Recently, Korean nursing academia has paid attention to authentic leadership [6]. Authentic leadership is a leadership where the leader treats individuals with authenticity, and has a characteristic of interacting with their members individually. Understanding and mediating the organizational culture of nurses, which constitutes a significant part of the hospital organization, has become an essential management strategy for effectively operating the hospital organization [6,7]. Previous studies on the factors identified before include the studies on the effects of authentic leadership and organizational culture on psychological capital and leader-member exchange (LMX) [4,8,9] and studies on the effects of psychological capital and leader-member exchange (LMX) on work meaning and work engagement, which are job attitudes [3,5,10]. However, most of the studies were conducted mainly on employees of companies and service organizations, and no empirical studies have been conducted on nurses. Therefore, this study aimed to investigate the effects of authentic leadership of the boss and organizational culture, perceived by nurses, on work meaning and work engagement, which are job attitudes, through the mediators, psychological capital and leader-member exchange (LMX) in clinical nurses and to provide fundamental data to promote the job attitudes of clinical nurses directly related to the public health.

Materials and Methods

This study is a path analysis study that establishes a hypothetical model on authentic leadership of the boss perceived by nurses, organizational culture, leader-member exchange, psychological capital, work meaning, and work engagement and verifies the model fit and hypotheses. The subjects were 301 nurses working at general hospitals with over 300 beds. Authentic leadership, organizational culture, psychological capital, leader-member exchange, work meaning, and work engagement were measured by using the Authentic Leadership Questionnaire [11], Organizational Culture Questionnaire [12], Leader Member Exchange scale [13], Psychological capital Questionnaire: PCQ [14], The Work and Meaning Inventory: WAMI [15], and Utrecht Work Engagement Scale: UWES-9 [16]. SPSS Windows 20.0 was used to analyse demographic characteristics of subjects and validity and reliability of study tools. AMOS 20.0 was used to verify the validity of the factors for constructing the structural equation model for nurses' job attitudes.

Results

As a result of verifying path coefficients, authentic leadership perceived by nurses had a positive effect on leader-member exchange (β=0.09, p<0.004), and organizational culture on psychological capital (β=0.56, p<0.004). Psychological capital (β=0.56, p<0.004) and leader-member exchange (β=0.19, p<0.008) had positive effects on work meaning. Psychological capital (β=0.41, p<0.004) and work meaning (β=0.56, p<0.004) had positive effects on work engagement. Among 10 hypotheses, 6 hypotheses were selected, the fit indices of the study model were χ2=447.81 (df=2, p=0.680), χ2/df=2.27, GFI=0.88, AGFI=0.85, RMRS=0.03, NFI=0.90, CFI=0.94, and RMSEA=0.07. Organizational culture perceived by nurses had a direct effect on increasing psychological capital (β=0.56, p=0.004), and authentic leadership had a direct effect on enhancing leader-member exchange (β=0.95, p=0.004). Organizational culture had an indirect effect on increasing work meaning (β=0.32, p=0.004), and psychological capital had a direct effect on increasing work meaning (β=0.56, p=0.004). Work meaning had a direct effect on enhancing work engagement (β=0.89, p=0.004), and organizational culture had an indirect effect on enhancing work engagement (β=0.41, p=0.004). In addition, psychological capital had a direct effect (β=0.62, p=0.004) and an indirect effect (β=0.33, p=0.004) on enhancing work engagement (Table 1).

Discussion

Organizational culture perceived by nurses had a direct effect on increasing psychological capital, which is consistent with the study result on service workers [17], suggesting that positive organizational culture perceived by nurses can increase psychological capital in the nursing organization as well. The result that authentic leadership had a direct effect on enhancing leader-member exchange is the same result as the study [18] on corporate employees, supporting the argument of Henderson et al. [5]. These results suggest that nurses' perception of the leader's authentic leadership positively affects the leader-member exchange. Psychological capital and leadermember exchange had direct effects on increasing work meaning. Authentic leadership and organizational culture had indirect effects on increasing work meaning through mediators, leader-member exchange and psychological capital, respectively. Particularly, in order to enhance work meaning, psychological capital and leader-member exchange were very important mediators. The result that psychological capital and leader-member exchange had direct effects on work meaning was found to be consistent with the results of a study [10] on Chinese corporate employees, a study [19] on U.S. corporate employees and a study [14] on U.S. nurses. Psychological capital and work meaning had direct effects on enhancing work engagement. Organizational culture and psychological capital had indirect effects on enhancing work engagement through mediators, psychological capital and leader-member exchange, respectively. Particularly, it was confirmed that psychological capital and work meaning are very important mediators to enhance work engagement. This result supports Steger’s argument [15], and it is considered that positive psychological factors and work meaning work as important factors to enhance work engagement. Therefore, the psychological factors covered in this study will be of practical help for education, counseling, and various programs to improve the job attitudes of nurses.